Antiplaque Efficacy of a Novel Moringa oleifera Dentifrice: A Randomized Clinical Crossover Study

Objectives The use of herbal dentifrices has grown exponentially over the years. They are categorically referred to as ethnomedicines. Various agents have been tried with contradicting findings based on phytopharmacological analysis. Miswak is one agent which has been used over the years. A novel Moringa oleifera-based dentifrice has shown promising results in terms of its cytotoxicity, biocompatibility, and as a potent anti-inflammatory agent. Therefore, the present study aims to compare the efficacy of two commercially available miswak- and moringa-based herbal dentifrices on the reduction of plaque and gingivitis scores. Materials and Methods This randomized clinical crossover study included 20 subjects with mild to moderate gingivitis. The study was conducted over a total examination period of 20 days with a wash-out period of 2 weeks between the use of both the toothpastes. The plaque index and gingival index of the study subjects were recorded at the designated time intervals throughout the study period. Statistical Analysis The data collected were entered on Microsoft Excel, and statistical analysis using SPSS software (SPSS version 28, IBM Corp, Armonk, New York, United States) was done. The statistical test used was the Wilcoxon signed-rank test. Moreover, p ≤0.05 was considered significant. Results The results showed that the reduction in mean gingival index scores from baseline to day 3 was more statistically significant in the moringa-based dentifrice. Similarly, the plaque index scores showed statistically significant reduction following the use of the moringa-based dentifrice when compared with the miswak dentifrice. This study reveals that the moringa dentifrice is a safe and effective agent in reducing plaque accumulation and treating gingival inflammation. Conclusion The current study aims to provide an insight into the possible role of moringa dentifrice as a possible adjunctive oral hygiene aid.

COMPARATIVE EVALUATION OF THE EFFICACY OF 4% MANGOSTEEN GEL AND 1% CHLORHEXIDINE DIGLUCONATE GEL IN MANAGEMENT OF PATIENTS WITH CHRONIC GINGIVITIS: A RANDOMIZED CLINICAL TRIAL

To clinically evaluate & compare the efficacy of 4% Mangosteen Gel and 1% chlorhexidine digluconate gel in managing patients with chronic gingivitis. Materials and Methods: A total of 50 patients with an age group of 20-45 years diagnosed with generalized plaque-induced gingivitis were selected for this clinical trial once attaining their informed consent. A thorough case history was chronicled comprising plaque index (P.I.), gingival index (G.I.) and Sulcus bleeding index (SBI) at baseline; then full-mouth scaling and polishing (SAP) was performed by a solitary attuned examiner. Patients were then randomly assigned into two groups using a computer-generated random numbering sequence system. Patients in group A received 4% Mangosteen Gel, and group B received 1% chlorhexidine digluconate gel for home application. The post-treatment follow-up examination for P.I., G.I. and SBI changes were assessed after 14 days and 21 days and compared with baseline data. Results: In both the groups, the mean plaque index, gingival index and sulcus bleeding index scores were significantly decreased after the 14th and 21st day compared to baseline scores. There was no significant difference between the groups, but only in group B, there was a substantial difference in SBI scores observed on day 21. Conclusion: 4% Mangosteen Gel and 1% chlorhexidine digluconate gel were clinically effective when used as an adjunct to SAP in managing patients with gingivitis. Hence, 4% Mangosteen Gel can be considered an alternative to 1% chlorhexidine digluconate gel without any side effects in managing generalized plaque-induced gingivitis.

Evaluating the Effect of Attached Gingiva Height on Pre-implant Tissue

Background: Many patients refer to their load implants while there is no attached gingiva in the area of prosthetic implants – unlike the attached gingivae found with natural teeth. The important role played by gingiva in comforting the patient and preventing gingival inflammation has not been fully appreciated yet. This study aimed to evaluate the association between the attached gingival height with gingival inflammation and patients’ comfort. Methods: This retrospective cohort study was conducted to examine 80 implants (Dio uf) placed in 63 patients. At least two months had passed since the patients had had implant crown. The patients were divided into three groups: attached gingiva, gingival up to 2 mm, and at least 2 mm of attached gingiva. Indices such as bleeding on probing (BOP), the amount of plaque, gingival index and patient comfort during brushing and chewing were evaluated. Statistical data were analyzed using the Kolmogorov– Smirnov test, Levene’s test and independent t-test. Results: By increasing the height of attached gingiva, decreases were observed in probing depth (P value=0.004), BOP (P value=0.001), the degree of plaque index (P value=0.006), and gingival index (P value=0.003); and this association was statistically quite significant. By increasing the attached gingiva height, furthermore, the patients felt less discomfort when brushing and chewing; however, the findings were not statistically significant in terms of patients’ comfort during chewing (P value=0.364). Conclusions: Increasing the height of attached gingiva reduced the symptoms of gingival inflammation, but increased patients’ comfort when chewing and brushing.

A Comparative Study of Fluoride Containing Chlorhexidine and Non Chlorhexidine Mouthrinses in a Teenage Group

Background: Mouthwashes are important means used in chemical control of dental plaque. There is strong evidence suggestive of better effectiveness, when fluoride is added to chlorhexidine mouthwash. Objectives: The study was planned to assess the effect of a mouthrinse containing Chlorhexidine (CHX) and amine/stannous fluoride (AmF) on plaque accumulation, gingivitis and salivary fluoride levels in comparison with two mouthrinses containing either essential oils (EO) or cetylpyridinium chloride (CPC) with sodium fluoride (NaF) in a teenage group. Methodology: For this study 90 healthy teenage between 12 and 20 years were recruited for participation. The experimental gingivitis model consisted of a 2-weeks recruitment phase, followed by a 6-day rinsing period with one of the 4 mouthrinse formulations was used for the study. At the end of the pre-phase period and the rinsing period (Day-0/Day-6), gingival index (GI), plaque index (PI) and salivary fluoride levels were recorded. The statistical analyses were performed using Wilcoxon sign test and the dependent t test. Results: A reduction in plaque re-growth was seen for the CHX+AmF formulation rinse, although there were no significant differences among all groups (p>0,001). During the experimental periods, the gingivitis indices increased significantly for all formulations (p<0,001), except for the CHX+AmF formulation. The CHX+AmF formulation scored higher levels of salivary fluoride at the end of the rinsing period (p>0,001). Conclusion: We would like to conclude that the adjunctive use of AmF containing CHX mouthrinses to mechanical oral hygiene should be recommended for teenage at risk groups. Keywords: CT KUB, Radiation safety, Minimise radiation

Analysis of Cosmetic Effect of Nanocomposite Resin on Anterior Teeth

The problems of anterior teeth include dental plaque, dental caries, and fracture, which are usually treated with common composite resin clinically. Although good repair effect can be achieved, patients are prone to anterior tooth sensitivity after surgery. Therefore, the purpose of this study is to analyze the cosmetic effect of nanocomposite resin on anterior teeth. Up to 176 patients (176 teeth) undergoing anterior dental cosmetic restoration in our hospital were selected and assigned to the LR group ( n = 88 ) and the NR group ( n = 88 ) according to patients’ voluntary choice of prosthetic materials. The LR group was cured with light-cured composite resin, while the NR group was cured with nanocomposite resin. By comparing the related indexes of patients in the two groups, it was discovered that in the NR group, the excellent and good rate and patients’ evaluation of the repair effect were higher, while the periodontal attachment, gingival index, dental plaque index, VAS score, and the incidence of tooth sensitivity were lower, all P < 0.05 . The results indicated that the nanocomposite resin had significant cosmetic effect on anterior teeth and had application value.

The Effect of Deep Traumatic Overbite on the Periodontium of the Upper Anterior Teeth in a Cohort of Adult Saudi Dental Patients

Aim: to assess the relationship between deep overbite with palatal impingement and periodontal health status in a cohort of adult Saudi dental patients. Materials and Methods:Ten patients (4 males and 6 females, aged 16 to 31 years old) with deep traumatic overbite and palatal impingement were examined. A Hawley retainer appliance with an anterior bite plate was provided for all patients.Pocket depth, bleeding index, gingival index, plaque index and mobility were recorded for four visits after using the appliance with fixed intervals in-between. Repeated measures analysis of variance (ANOVA) was used to assess the differences between visits, control /experimental teeth and surfaces (palatal /labial) for pocket depth, bleeding index, plaque index,gingival index and mobility.

Clinical evaluation of excisional new attachment procedure versus laser assisted new attachment procedure in the treatment of periodontal pockets

TheLaser Assisted New Attachment Procedure (LANAP) protocol is a laser based periodontal regenerative procedure and was patterned, conceptually, after the Excisional New Attachment Procedure (ENAP) to separate the diseased epithelium from the underlying connective tissue and to selectively vaporize and disrupt inflamed and necrotic tissue from connective tissue.: The present study was designed to compare and evaluate the clinical efficacy of LANAP versus ENAP in the treatment of chronic periodontitis.: Twenty periodontal pocket sites of ≥5mm in systemically healthy patients were selected and randomly allocated to either (ENAP) Excisional New Attachment Procedure (Group I) or (LANAP) Laser Assisted New Attachment Procedure (Group II). Patients were evaluated for Plaque Index, Gingival Index, Gingival Bleeding Index, Probing Depth, Loss of attachment, recession and VAS scores. Patients were recalled for follow up at 1 week, 1 month and 3 months at which clinical parameters were recorded.: The results of the present study revealed statistically insignificant difference in both groups however clinically significant reduction in probing depth was seen with ENAP as compared to LANAP but laser procedure had less VAS scores as compared to ENAP.Although probing depth reduction was more for ENAP, patient discomfort with less bleeding was observed with LANAP.

Evaluation of Oral and Dental Health Status in Pregnant Women Referring to Fatemieh Hospital in Hamadan City during 2018

Introduction: Physiological changes during pregnancy affect the teeth and tissues of the mouth and gums, which increases the severity of problems such as caries, inflammation, bleeding and swelling of the gum. Therefore, pregnant people need regular check-ups and provide adequate education. The aim of this study was evaluation of oral and dental health status in pregnant women referring to Fatemieh Hospital in Hamadan City during 2018. Methods: This study was performed on 96 pregnant women. The adjusted questionnaire was completed for each individual by interview method in order to complete the section on personal and pregnancy data and examination in order to complete the section on oral and dental health status. Statistical analysis was performed using SPSS version 16 software. Results: The mean age of the participants was 29.64. The Decay Missing Filling Teeth (DMFT) index in pregnant women was 10.48 ± 3.81. 75.74% of the participants were positive in terms of BOP. 12.50% had dry mouth. Using gingival index, 68.75% of the subjects had gingivitis and the mean gingival index was 0.98 ± 0.79%. In terms of oral hygiene, using the index plaque assessment, the majority of the participants was moderate (45.83%) and the mean plaque index was 1.27 ± 0.62%. Conclusion: Pregnant mothers have a moderate oral health. For this reason, it is necessary to inform physicians in order to refer them to dentists and educate pregnant women to observe oral hygiene and prevent the occurrence of oral diseases and gingivitis in pregnancy.

Effectiveness of Different Educational Methods on Oral Health in 7-13-year-old Visually Impaired Children in Tehran: A Randomized Trial

Background: Conventional oral health education is not suitable for visually impaired children. Objectives: Considering the importance of oral health, this study aimed to investigate the effectiveness of different educational methods on oral hygiene status. Methods: Following a clinical trial design, 88 visually impaired children, aged 7 to 13 years, living in Tehran were recruited and randomly allocated to four groups of verbal-tactile, verbal-braille, multisensory, and control. Initially, all children were well informed about the importance of oral hygiene; then, the baseline levels of plaque score and gingivitis were recorded by Silness & Loe plaque index and Loe & Silness gingival index, respectively. Experimental groups received oral health education through different methods. The instructions were repeated after one month, and plaque and gingival indices were reevaluated after two months. Data analysis was administered by analysis of variance (ANOVA) and posthoc tests using SPSS 20.0. Results: After receiving the intervention, all groups showed a decrease in plaque and gingival indices, with the most reduction in the multisensory group (with a statistically significant difference (P = 0.0001) between multisensory & control for both plaque & gingival indices). The least change was observed in the verbal-braille group compared to the control (for plaque index and gingival index after two months (P = 0.04) and (P = 0.17), respectively). Conclusions: This study demonstrated that the multisensory method (verbal-tactile-braille) is the best option to educate visually impaired children, with significantly more acceptable results.

The Prevalence and Extent of Physiological and Pathological Gingival Pigmentation in Patients Visiting Riyadh Elm University Clinics

Background: Gingival pigmentation presents as a diffuse deep discoloration or as irregularly shaped brown and light brown or black patches, striate, or strands. It is generally agreed that pigmented areas are solely pre-sent when melanin granules, synthesized by melanocytes, are transferred to keratinocytes. Aim: To study the prevalence, extent, and etiology of gingival pigmentation among Riyadh Elm University clin-ics’ attendees. Design and Settings: Examinations were done in Riyadh Elm University by four calibrated examiners. Methods: Patients underwent a Gingival Index examination, followed by an assessment of the presence or ab-sence of gingival pigmentations. If the latter were present, the patient underwent a Hedin’s Melanin Index, a Gingival Melanosis Record, and a Von Luschan Scale examination to evaluate the extent, distribution, and col-or of the pigmentation. Statistical analysis: Cohen’s Kappa Test and Chi-Square Test Results: A total of 139 (80.3%) patients had gingival pigmentation, of which 79 (56.8%) were males. Gingival pigmentations were found in 42 (93.3%) cigarette smokers, 40 (83.3%) hubbly bubbly smokers, and 20 (86.9%) electronic cigarette smokers. Both arches were affected in 102 patients, the canines’ area had the highest incidence of pigmentation (88.9%) while the molars had the least incidence (18.1%). Scores of 2 and 3 on the Hedin’s Index were the highest at 51 and 52 patients respectively. The mean color of the pigmentations on the Von Luschan scale was 21.49 ± 4.59, but it was higher for smokers and patients with severe inflamma-tion. Conclusions : Gingival pigmentation was more prevalent among all types of smokers—cigarettes, hubbly bubbly, and e-cigarettes compared to non-smokers. More pigmentations were also associated with the higher intake. The major patterns of pigmentation distribution were the short-connected-continuous ribbons and the more-than-two-solitary-papillae. Keywords: Gingival Pigmentation, Hedin’s Index, Color, Distribution, Smokers